On May 6 and 7, 2000 South Africa would have taken yet another major step in the fight against HIV/AIDS. The Presidential Aids Advisory Council would have met to consider key questions such as:
What causes the immune deficiency leading to AIDS? What is the best response to these causes? Why is HIV/AIDS in Southern Africa hetero-sexually transmitted?
What are the drug based responses for developing countries? What responses are appropriate for people with HIV/AIDS; for preventing mother-to-child transmission; or for preventing transmission after rape?
The discussions would have been located within the conditions of dire poverty and diseases such as TB and Malaria experienced by the majority of South Africans. We present here answers to some of the key questions you may have about Government's stance.
It sounds like the days when the apartheid government banned people from speaking in public.
Precisely. As the President points out, it was not so long ago that our people were killed, tortured, imprisoned and prohibited from being quoted because the authorities believed their views were dangerous and discredited.
"We are now being asked to do precisely the same thing that the racist apartheid tyranny did because, it is said, there exists a scientific view that is supported by the majority, against which dissent is prohibited."
"The scientists we are supposed to put into scientific quarantine include Nobel Prize winners, members of Academies of Science and Emeritus Professors of various disciplines of medicine". The tragic irony, the President says, is that "people who otherwise would fight very hard to defend freedom of thought and speech occupy the front-line in the campaign of intellectual intimidation and terrorism" with regard to the HIV-AIDS issue.
"They argue that the only freedom we have is to agree with what they decree to be established scientific truths".
The President's recent comments on HIV-AIDS seem to have stirred up some controversy. Why?
In his recent letter to President Clinton, our President was very direct on the need to urgently find appropriate ways to treat and prevent HIV-AIDS in South Africa.
For one thing, he's saying the world should not limit its investigations into the causes of HIV-AIDS. The disease poses such a massive threat to humanity that we should explore every possible avenue, he says. We should not close our minds to possible solutions, no matter how much that flies in the face of conventional wisdom.
Secondly, the President is saying the nature of HIV-AIDS in Africa poses specific challenges. HIV-AIDS is devastating sub-Saharan Africa - and the President believes that Africa needs to map out its own response to this.
Thirdly, the President has questioned the effectiveness of AIDS treatments such as AZT, and argued that there should be ongoing tests into their effectiveness before they are prescribed on a large scale.
But why are these views controversial?
As the President says, there is an "orchestrated campaign of condemnation" against anyone who dares to challenge conventional wisdom on the treatment of HIV-AIDS at the moment.
"Scientists, in the name of science, are demanding that we should co-operate with them to freeze scientific discourse on HIV-AIDS at the specific point this discourse had reached in the West in 1984," he says.
Some people have suggested that South Africa should only be drawing on the advice of certain scientists. It has been suggested, for instance, that some scientist are "dangerous and discredited", and that nobody should communicate or interact with them. This is an absurd argument: as the President says, "in an earlier period in human history, these dangerous scientists would be heretics and they would be burnt at the stake!"
It sounds like the government is just setting up committees.
Not at all - even though these committees are important structures in themselves. It's important to note that the government has also launched several highly successful high-profile campaigns to encourage safe sex and the use of condoms.
It has set up a dedicated fund to finance the fight against HIV-AIDS. This is in addition to funds that central, provincial and local government will spend on this campaign.
The government is funding work that is being done by the Medical Research Council to develop an AIDS vaccine.
Similarly, it is doing everything possible to provide the necessary treatment and care for those affected by HIV-AIDS.
"As a government and a people, we are trying to organise ourselves to ensure that we take care of the children affected and orphaned to AIDS, "the President states in his letter.
"We are also ensuring that no section of our society – whether public or private – discriminate against people suffering from HIV-AIDS."
At the same time, as an essential part of the campaign against HIV-AIDS, the government is focusing on the elimination of poverty.
So what is President Mbeki and his government actually doing about HIV-AIDS?
In his letter to President Clinton, the President is unequivocally clear on government's commitment to fighting HIV-AIDS.
He points out how, since 1998, the government has radically stepped up its campaign. It has done this in many ways, including the establishment of three powerful structures:
- A Ministerial Task Force, chaired by the Deputy President, to ensure a co-ordinated government response
- A Partnership Against AIDS, to ensure co-ordinated action by civil society - including the youth, women, business, unions and the religious community
- A high-powered National AIDS Council, again chaired by the Deputy President, which brings together government and civil society
Just how much of a threat is HIV-AIDS? And why is the President so involved at the moment?
South Africa is among the worst infected countries in the world. International organisations such as UNAIDS have reported that Sub-Saharan Africa accounts for two-thirds of the world's incidence of HIV-AIDS.
UNAIDS and World Health Organisation reports for 1998 said AIDS was responsible for one death in five in Africa - or about two million people. UNAIDS believes there are 23 million carriers in Africa of HIV.
The same report says: " In Southern Africa, the prevalence of the infection has increased so much in five years that this region could, if the epidemic continues to spread at this rate, see its life expectancy decline to 47 by 2005."
The report went on to say that almost 1 500 people are infected in South Africa every day and that, at that point, the equivalent of 3,8-million people in our country carried the virus.
Dealing with a threat of this nature requires the focus on the entire government, which is why the President has become closely involved in attempts to control the spread of HIV-AIDS, to influence behaviour, and to try to find a vaccine.
But why does the President insist that the approach to HIV-AIDS should be different in Africa?
As the President points out in his letter to President Clinton, we face a uniquely African catastrophe.
- Contrary to the West, where HIV-AIDS primarily affects homosexual men it is heterosexually transmitted in Africa
- Contrary to the West, where relatively few people have died from AIDS, millions have died in Africa; and,
- Contrary to the West, where AIDS deaths are declining, even greater numbers of Africans are destined to die.
The President's concerns are clear: "Whatever lessons we draw from the West about HIV-AIDS, it would be absurd and illogical to make a simple superimposition of Western experience on African reality." The President highlighted the urgency of responding to the specific threat that faces us as Africans. "We will not eschew our obligation in favour of. what may well be a correct response to the manifestation of AIDS in the West, " he said.
"We will not condemn our own people to death by giving up the search for specific and targeted responses to the specifically African incidence of HIV-AIDS."
Ignoring reality, the President says, "would constitute a criminal betrayal of our responsibility to our own people."
Is it true, then, that the President will not allow people with HIV-AIDS to receive medication?
Nothing could be further from the truth. No one in South Africa is prohibited from issuing, or getting access to, drugs such as AZT.
But it would be irresponsible for the government to issue medication if it wasn't absolutely sure of the consequences, and this is why the government is insisting on very strict testing of these drugs. These tests are underway at the moment, and are aimed at assessing the toxicity of drugs and the affordability.
The results of the tests will obviously influence future government decisions.
Compiled by: Joel Netshitenzhe, CEO: GCIS